(2) Trauma to stoma caused by improper fitting

pouch. A wafer cut too close to the stoma can

injure the delicate tissue. Stomal lacerations

can occur as a result of the edge of the wafer

rubbing back and forth against the side of the

stoma (4).

b. Necrosis: Caused by ischemia and may be superficial or deep. Necrosis extending below the facial

level may lead to perforation and peritonitis, requiring additional surgical intervention (4).

c. Mucocutaneous separation: This condition is caused

by a breakdown of the suture line securing the stoma

to the surrounding skin, leaving an open wound

next to the stoma.

d. Prolapse: Telescoping of the bowel out through the

stoma. In infants, this condition is frequently related

to poorly developed fascial support or excessive

intra-abdominal pressure caused by crying.

e. Retraction: The stoma is flush or recessed below the

skin surface. This condition may result from insufficient mobilization of the mesentery or excessive tension on the suture line at the fascial layer, excessive

scar formation, or premature removal of a support

device (4).

f. Stenosis: The lumen of the ostomy narrows at either

the cutaneous level or the fascial level. Sudden

decrease in output may indicate stenosis.

9. Peristomal complications

a. Dermatitis

(1) Allergic dermatitis

C

B

A